LONDON —
An expert panel examining euthanasia deaths in Canada’s most populous province has identified several cases in which patients requested assisted dying in part for social reasons, such as isolation and fear of homelessness, which has raised concerns about the approval of this procedure for vulnerable people.
Ontario’s chief coroner issued several reports Wednesday — following an investigation by The Associated Press, based in part on data provided in one of the documents — in which he reviewed euthanasia deaths of people who were not terminally ill. . The expert commission’s reports are based on an analysis of anonymous cases, chosen for their implications for future euthanasia requests.
Canada’s legal criteria require there to be a medical reason for approving euthanasia — a fatal diagnosis or uncontrollable pain — but the commission’s reports show cases in which some people were euthanized based on other factors, including a “ unmet social need.
The AP investigation found that doctors and nurses were privately grappling with requests to euthanasia from vulnerable people whose suffering could be resolved with money, social connections or adequate housing. Medical providers expressed discomfort with assisting in the deaths of vulnerable people whose deaths were preventable, even if they met the criteria in Canada’s euthanasia system, known nationally as MAiD, for medical assistance in dying.
“Finally having a government report that recognizes these worrying cases is extremely important,” said Dr. Ramona Coelho, who belongs to the expert commission. “For many years we have been taken to task when we raised fears that people received MAiD because they were poor, disabled or socially isolated.”
In the case of a man identified as Mr. A, the Ontario expert commission questioned whether authorities tried hard enough to alleviate his pain before he was euthanized. Mr A was an unemployed man in his early 40s with intestinal disease and a history of substance abuse and mental illness. He was described as “socially vulnerable and isolated”. Some commission members were alarmed that a psychiatrist had recommended euthanasia during a mental health evaluation.
Mr. A was picked up and taken to the euthanasia site by the medical professionals in charge of the procedure, a violation of professional boundaries, according to some members of the commission. They said that could have “created pressure and given rise to a perception of rushing a person toward death.”
Another case concerned Mrs B, a woman over 50 years old suffering from multiple chemical sensitivity syndrome, with a history of mental illness including suicide and post-traumatic stress disorder. She lived socially isolated and asked to die largely because she could not obtain adequate housing, according to the report.
The commission members could not agree on whether his death was justified; some claimed that since her inadequate housing was the main reason for her suffering, she should have been disqualified from euthanasia. Others argued that “social needs may be considered irremediable” if other options have been explored.
